36C24121Q0031.docx

36C24121Q0031

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1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

DUNS:

DUNS+4:

PHONE:

FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only) 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

402-21-2-7918-0002 36C24121Q0031 Mark A. Gelsinger 207-623-8411 Ext 2222 10-27-2020

10:00 AM

EDT

Department of Veterans Affairs Network Contracting Office 1 (NCO-1) 830 Chalkstone Avenue Providence RI 02908 X 621111 $12 Million N/A X Department of Veterans Affairs VA Maine HCS 1 VA Center Attn: Medical Service Augusta ME 04330 Department of Veterans Affairs Network Contracting Office 1 (Code 90C) 830 Chalkstone Avenue Providence RI 02908

Department of Veterans Affairs Financial Services Center http://www.fsc.va.gov/einvoice.asp P.O. Box 149971 Austin TX 78714-9971 See CONTINUATION Page Provide weekend, holiday, evening and night on-call coverage for Nephrology Services to teh VA Maine Healthcare System - Togus. All services are to be performed in accordance with the Performance Work Statement.

Contractors are directed to the following paragraphs:

Please refer to Section B.3 on page 26 for the Price Schedule.

Please refer to Section E.2 on page 77 for the Instructions to Quoters.

The Point of Contact for this Solictation is Mark Gelsinger, Contracting Officer, mark.gelsinger@va.gov.

See CONTINUATION Page X X

MARK A. GELSINGER

Contracting Officer Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C241 Mr. Mark A. Gelsinger Department of Veterans Affairs Network Contracting Office 1 (NCO-1) 830 Chalkstone Avenue Providence RI 02908

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

3. INVOICES: Invoices shall be submitted in arrears:

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

Department of Veterans Affairs Financial Services Center http://www.fsc.va.gov/einvoice.asp P.O. Box 149971 Austin TX 78714-9971 ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

36C24121Q0031

Page 1 of Page 1 of

B.2 PERFORMANCE WORK STATEMENT

Performance Work Statement for Onsite Nephrology Services

1. GENERAL:

1.1. Services Provided: The Contractor shall provide Board Eligible/Board Certified Nephrology Provider Services on site in accordance with the specifications contained herein to beneficiaries of the Department of Veterans Affairs (VA) and the Togus VAMC, Augusta, ME.

1.1 Place of Performance – Services shall be provided via telephone within 15 minutes and in-person within 90 minutes at VAMC Togus, One VA Center, Augusta, ME 04330

1.2. Authority: Title 38 USC 8153, Health Care Resources (HCR) sharing Authority.

1.3. Policy/Handbooks:

1.3.1. VA Directive 1663: Health Care Resources Contracting - Buying https://www.va.gov/vapubs/viewPublication.asp?Pub_ID=969&FType=2

1.3.2. VHA Handbook 1100.17: National Practitioner Data Bank Reports - https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2135

1.3.3. VHA Handbook 1100.18 Reporting And Responding To State Licensing Boards - https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=1364

1.3.4. VHA Handbook 1100.19 Credentialing and Privileging - https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=2910

1.3.5. VHA Directive 1192.01 Seasonal Influenza Vaccination Program for VHA Health Care Personnel https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=8948

1.3.6. VHA Handbook 1907.01 Health Information Management and Health Records: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3088

1.3.7. Privacy Act of 1974 (5 U.S.C. 552a) as amended

https://www.justice.gov/opcl/privacy-act-1974

1.4. Definitions/Acronyms- Terms used in this contract shall be interpreted as follows unless the context expressly requires a different construction and/or interpretation. In case of a conflict in language between the Definitions and other sections of this contract, the language in this section shall govern.

1.4.1. ASN: American Society of Nephrology http://www.asn-online.org

1.4.2. ACGME: Accreditation Council for Graduate Medical Education

1.4.3. ACLS: Advanced Cardiac Life Support

1.4.4. AOD: Admitting Officer of the Day

1.4.5. BLS: Basic Life Support

1.4.6. CCNE: Commission on Collegiate Nursing Education: www.aacnnursing.org/CCNE

1.4.7. CDC: Centers for Disease Control and Prevention

1.4.8. CDR: Contract Discrepancy Report

1.4.9. CEU: Certified Education Unit

1.4.10. CME: Continuing Medical Education

1.4.11. CMS: Centers for Medicare and Medicaid Services

1.4.12. Contracting Officer (CO) – The person executing this contract on behalf of the Government with the authority to enter into and administer contracts and make related determinations and findings.

1.4.13. Contracting Officer’s Representative (COR) – A person appointed by the CO to take necessary action to ensure the Contractor performs in accordance with and adheres to the specifications contained in the contract and to protect the interest of the Government. The COR shall report to the CO promptly any indication of non-compliance in order that appropriate action can be taken.

1.4.14. COS: Chief of Staff

1.4.15. CPARS: Contractor Performance Assessment Reporting System

1.4.16. CPRS: Computerized Patient Recordkeeping System- electronic health record system used by the VA.

1.4.17. Credentialing: Credentialing is the systematic process of screening and evaluating qualification and other credentials, including licensure, required education, relevant training and experience and current competence and health status.

1.4.18. DEA: Drug Enforcement Agency

1.4.19. ED: Emergency Department

1.4.20. FSMB: Federation of State Medical Boards

1.4.21. Full Time Equivalent (FTE): VA’s definition for full time- working the equivalent of 80 hours every two weeks, 2080 hours per year. In calculating FTE, any hours not worked on national holidays shall not be included.

1.4.22. HHS: Department of Health and Human Services

1.4.23. HIPAA: Health Insurance Portability and Accountability Act

1.4.24. HR: Human Resources

1.4.25. ISO: Information Security Officer

1.4.26. Medical Emergency - a sudden onset of a medical condition manifesting itself by acute symptoms of sufficient severity that the absence of immediate medical attention could reasonably result in: Permanently placing a patient's health in jeopardy, causing other serious medical consequences, causing impairments to body functions, or causing serious or permanent dysfunction of any body-organ or part.

1.4.27. MOD: Medical Officer of the Day

1.4.28. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers).

1.4.29. NLNAC: National League for Nursing Accrediting Commission. www.nlnac.org

1.4.30. Non-Contract Provider - any person, organization, agency, or entity that is not directly or indirectly employed by the Contractor or any of its subcontractors

1.4.31. NP: Nurse Practitioner

1.4.32. NPPES: National Plan and Provider Enumeration System

1.4.33. PA: Physician Assistant

1.4.34. PALS: Pediatric Advanced Life Support

1.4.35. POP: Period of Performance

1.4.36. PPD: Purified Protein Derivative

1.4.37. PWS: Performance Work Statement

1.4.38. Privileging (Clinical Privileging): Privileging is the process by which a practitioner, licensed for independent practice; e.g., without supervision, direction, required sponsor, preceptor, mandatory collaboration, etc.; is permitted by law and the facility to practice independently, to provide specific medical or other patient care services within the scope of the individual’s license, based upon the individual’s clinical competence as determined by peer references, professional experience, health status, education, training and licensure. Clinical privileges must be facility-specific and provider-specific.

1.4.39. QASP: Quality Assurance Surveillance Plan

1.4.40. Veterans Health Administration (VHA): The central office for administration of the VA medical centers through throughout the United States. The VHA is located in Washington, D.C.

1.4.41. Veterans Integrated Services Network (VISN): The regional oversight for the VA medical centers in Michigan and Indiana.

1.4.42. VISTA (Veterans Integrated Systems Technology Architecture): A PC based system that will capture and store clinical imagery, scanned documents and other non-textual data files and integrates them into patient’s medical record and with the hospital information system.

1.4.43. VetPro: a federal web-based credentialing program for healthcare providers.

1.4.44. Veterans Affairs Medical Center (VAMC): Unless identified with the name of a different VA Medical Center, for purposes of this contract, this term shall mean the Togus VA Medical Center.

2. QUALIFICATIONS:

2.1. Staff/Facility

2.1.1. License - Contract provider (s) assigned by the Contractor to perform the services covered by this contract shall have a current license to practice medicine in any State, Territory, or Commonwealth of the United States or the District of Columbia. Contract providers must have a medical license and be individually registered with the DEA in the state where they will provide services under the contract. All licenses held by the personnel working on this contract shall be full and unrestricted licenses. Contract provider (s) who have current, full and unrestricted licenses in one or more states, but who have, or ever had, a license restricted, suspended, revoked, voluntarily revoked, voluntarily surrendered pending action or denied upon application will not be considered for the purposes of this contract.

2.1.2. Board Certification -. All contract Nephrology provider(s) shall be Board Eligible/Board Certified by the American Board of Internal Medicine in Nephrology http://www.abim.org/specialty/nephrology.aspx, and be currently certified in Basic Life Support (BLS) or Advanced Cardiac Life Support (ACLS). All continuing education courses required for maintaining certification must always be kept up to date.

Documentation verifying current certification shall be provided by the Contractor to the VA COR on an annual basis for each year of contract performance.

2.1.3. Credentialing and Privileging –Credentialing and privileging is to be done in accordance with the provisions of VHA Handbook 1100.19 referenced above. The Contractor is responsible to ensure that proposed provider(s) possesses the requisite credentials enabling the granting of privileges. No services shall be provided by any contract provider(s) prior to obtaining approval by the Togus VAMC Professional Standards Board, Medical Executive Board and Medical Center Director.

2.1.4. If a contract provider(s) is not credentialed and privileged or has credentials/privileges suspended or revoked, the Contractor shall furnish an acceptable substitute without any additional cost to the government.

2.1.5. Technical Proficiency - Contract provider(s) shall be technically proficient in the skills necessary to fulfill the government’s requirements, including the ability to speak, understand, read and write English fluently. Contractor shall provide documents upon request of the CO/COR to verify current and ongoing competency, skills, certification and/or licensure related to the provision of care, treatment and/or services performed. Contractor’s physicians shall have knowledge of professional care theories, principles, practices, and procedures to perform assignments of Nephrology patient/critically ill patient population. Contractor’s physician shall demonstrate knowledge of growth and development, and pathophysiology of disease processes specific to the critical care/nephrology population Contractor shall provide verifiable evidence of all educational and training experiences including any gaps in educational history for all contract provider (s)and contract physician (s) shall be responsible for abiding by the Facility's Medical Staff By-Laws, rules, and regulations (referenced herein) that govern medical staff behavior.

2.1.6. Continuing Medical Education (CME)/ Certified Education Unit (CEU) Requirements: Contractor shall provide the COR copies of current CMEs as required or requested by the VAMC. Contract physician (s) registered or certified by national/medical associations shall continue to meet the minimum standards for CME to remain current. Contractor shall report CME hours to the credential’s office for tracking. These documents are required for both privileging and re-privileging. Failure to provide shall result in loss of privileges for contract physician(s).

2.1.7. Training (ACLS, BLS, CPRS and VA MANDATORY): Contractor shall meet all VA educational requirements and mandatory course requirements defined herein; all training must be completed by the contract physician (s) as required by the VA. Completes all mandatory training including new employee orientation upon arrival at the medical center. In addition, completes any other mandatory training as assigned by the Chief of Medicine or COR. This may include, but is not limited to: Infection Control, Information Security, Fire, Safety, Military Cultural Awareness, Sexual Harassment, etc.

2.1.8. Standard Personnel Testing (PPD, etc.): Contractor shall provide proof of the following tests for physicians within five (5) calendar days after contract award and prior to the first duty shift to the COR and Contracting Officer. Tests shall be current within the past year.

2.1.8.1. TUBERCULOSIS TESTING: Contractor shall provide proof of a negative Tuberculosis Skin Test (TST) or interferon-gamma release assays (IGRA) for all Contractor’s physicians. A negative chest radiographic report for active tuberculosis shall be provided in cases of positive TST or IGRA results. The TST or IGRA testing shall be repeated annually.

2.1.8.2. MEASLES, MUMPS, & RUBELLA TESTING: Contractors shall provide proof of immunity for all Contractor physicians.

2.1.8.3. VARICELLA: Contractors shall provide proof of immunity for all Contractor physicians.

2.1.8.4. ACELLULAR PERTUSSIS: Contractors shall provide proof of 1 dose of Tdap vaccination for all Contractor physicians.

2.1.8.5. INFLUENZA: Contractors shall provide proof that all Contractor physicians have received the annual Influenza vaccine unless it is contraindicated. If the Contractor physician has a medical contraindication to the vaccine, they shall be required to wear a mask during the Influenza season.

2.1.8.6. OSHA REGULATION CONCERNING OCCUPATIONAL EXPOSURE TO BLOODBORNE PATHOGENS: Contractor shall provide evidence of completing and passing generic self-study blood-borne pathogen training for all Contractor’s physicians; provide their own Hepatitis B vaccination series and hepatitis B surface antigen test results following the hepatitis B vaccination series; maintain an exposure determination and control plan; maintain required records; and ensure that proper follow-up evaluation is provided following an exposure incident.

2.1.8.7. The VAMC shall notify the Contractor of any significant communicable disease exposures as appropriate. Contractor shall adhere to current CDC/HICPAC Guideline for Infection Control in health care personnel ( as published in American Journal for Infection Control- AJIC 1998; 26:289-354 http://www.cdc.gov/hicpac/pdf/InfectControl98.pdf) for disease control. Contractor shall provide follow up documentation of clearance to return to the workplace prior to their return.

2.1.9. National Provider Identifier (NPI): NPI is a standard, unique 10-digit numeric identifier required by HIPAA. The Veterans Health Administration must use NPIs in all HIPAA-standard electronic transactions for individual (health care practitioners) and organizational entities (medical centers). The Contractor shall have or obtain appropriate NPI and if pertinent the Taxonomy Code confirmation notice issued by the Centers for Medicare and Medicaid Services (CMS) National Plan and Provider Enumeration System (NPPES) be provided to the Contracting Officer with the proposal.

2.1.10. DEA (as required) - Contractor shall provide copy of current Federal or Maine DEA certificate.

2.1.11. Conflict of Interest: The Contractor and all contract physician(s) are responsible for identifying and communicating to the CO and COR conflicts of interest at the time of proposal and during the entirety of contract performance. At the time of proposal, the Contractor shall provide a statement which describes, in a concise manner, all relevant facts concerning any past, present, or currently planned interest (financial, contractual, organizational, or otherwise) or actual or potential organizational conflicts of interest relating to the services to be provided. The Contractor shall also provide statements containing the same information for any identified consultants or subcontractors who shall provide services. The Contractor must also provide relevant facts that show how it’s organizational and/or management system or other actions would avoid or mitigate any actual or potential organizational conflicts of interest. These statements shall be in response to the VAAR provision 852.209-70 Organizational Conflicts of Interest (Jan 2008) and fully outlined in response to the subject attachment in Section D of the solicitation document.

2.1.12. Citizenship related Requirements:

2.1.12.1. The Contractor certifies that the Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services to Department of Veterans Affairs patient referrals.

2.1.12.2. While performing services for the Department of Veterans Affairs, the Contractor shall not knowingly employ, contract or subcontract with an illegal alien; foreign national non-immigrant who is in violation their status, as a result of their failure to maintain or comply with the terms and conditions of their admission into the United States. Additionally, the Contractor is required to comply with all “E-Verify” requirements consistent with “Executive Order 12989” and any related pertinent Amendments, as well as applicable Federal Acquisition Regulations.

2.1.12.3. If the Contractor fails to comply with any requirements outlined in the preceding paragraphs or its Agency regulations, the Department of Veterans Affairs may, at its discretion, require that the foreign national who failed to maintain their legal status in the United States or otherwise failed to comply with the requirements of the laws administered by Homeland Security, Immigration and Customs Enforcement and the U.S Department of Labor, shall be prohibited from working at the Contractor’s place of business that services Department of Veterans Affairs patient referrals; or other place where the Contractor provides services to veterans who have been referred by the Department of Veterans Affairs; and shall form the basis for termination of this contract for breach.

2.1.12.4. This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under 18 U.S.C. 1001.

2.1.12.5. The Contractor agrees to obtain a similar certification from its subcontractors. The certification shall be made as part of the offerors response to the RFP using the subject attachment in Section D of the solicitation document.

2.1.13. Annual Office of Inspector General (OIG) Statement: In accordance with HIPAA and the Balanced Budget Act (BBA) of 1977, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) has established a list of parties and entities excluded from Federal health care programs. Specifically, the listed parties and entities may not receive Federal Health Care program payments due to fraud and/or abuse of the Medicare and Medicaid programs.

2.1.13.1. Therefore, Contractor shall review the HHS OIG List of Excluded Individuals/Entities on the HHS OIG web site at http://oig.hhs.gov/exclusions/index.asp to ensure that the proposed contract physician(s) are not listed. Contractor should note that any excluded individual or entity that submits a claim for reimbursement to a Federal health care program, or causes such a claim to be submitted, may be subject to a Civil Monetary Penalty (CMP) for each item or service furnished during a period that the person was excluded and may also be subject to treble damages for the amount claimed for each item or service. CMP’s may also be imposed against the Contractor that employ or enter into contracts with excluded individuals to provide items or services to Federal program beneficiaries.

2.1.13.2. By submitting their proposal, the Contractor certifies that the HHS OIG List of Excluded Individuals/Entities has been reviewed and that the Contractors are and/or firm is not listed as of the date the offer/bid was signed.

2.2. Clinical/Professional Direction: The qualifications of Contractor personnel are subject to review by VA Medical Center COS or his/her clinical designee and approval by the Medical Center Director as provided in VHA Handbook 1100.19. Clinical/Professional direction of all clinical personnel covered by this contract will be provided by the VAMC COS and/or the Chief of the Service or his designee. A clinical COR may be appointed, however, only the CO is authorized to consider any contract modification request and/or make changes to the contract during the administration of the resultant contract.

2.3. Non-Personal Healthcare Services: The parties agree that the Contractor and all contract physician(s) shall not be considered VA employees for any purpose.

2.4. Inherent Government Functions: Contractor and Contract physician (s) shall not perform inherently governmental functions. This includes, but is not limited to, determination of agency policy, determination of Federal program priorities for budget requests, direction and control of government employees (outside a clinical context), selection or non-selection of individuals for Federal Government employment including the interviewing of individuals for employment, approval of position descriptions and performance standards for Federal employees, approving any contractual documents, approval of Federal licensing actions and inspections, and/or determination of budget policy, guidance, and strategy.

2.5. No Employee status: The Contractor shall be responsible for protecting Contract physician (s) furnishing services. To carry out this responsibility, the Contractor shall provide or certify that the following is provided for all their staff providing services under the resultant contract:

2.5.1. Workers’ compensation

2.5.2. Professional liability insurance

2.5.3. Health examinations

2.5.4. Income tax withholding, and

2.5.5. Social security payments.

2.6. Tort Liability: The Federal Tort Claims Act does not cover Contractor or contract provider(s). When a Contractor or contract physician(s) has been identified as a provider in a tort claim, the Contractor shall be responsible for notifying their legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor’s (or contract physician(s)) action or non-action shall be the responsibility of the Contractor and/or insurance carrier.

2.7. Key Personnel:

2.7.1. The VA Full Time Equivalency (FTE) for the services required is three (3). FTE is defined by VA as a minimum of 80 hours every two weeks and does not include holidays.

2.7.2. The number of Board Eligible/Board Certified Nephrology providers required to provide call coverage on a daily basis is one (1) as defined in paragraph Hours of Operation in this section.

2.7.3. The Contract shall be limited to a maximum of 10 providers.

2.8. Emergency Substitutions: During the first ninety (90) calendar days of performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death or termination of employment. The Contractor shall notify the CO, in writing, within 15 calendar days after the occurrence of any of these events and provide the information required below. After 90 days, the Contractor shall submit the information required below to the CO at least 15 calendar days prior to making any permanent substitutions.

2.8.1. The Contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, complete resumes for the proposed substitutes, and any additional information requested by the CO. Proposed substitutes shall have comparable qualifications to those of the persons being replaced. The CO will notify the Contractor within 15 calendar days after receipt of all required information of the decision on the proposed substitutes. The contract will be modified to reflect any approved changes of key personnel.

2.8.2. For temporary substitutions where the key person shall not be reporting to work for three (3) consecutive workdays or more, the Contractor shall provide a qualified replacement for the key person. The substitute shall have comparable qualifications to the key person. Any period exceeding two weeks will require the procedure as stated above.

2.8.3. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. Should the VA COS or designee show documented clinical problems or continual unprofessional behavior/actions with any contract physician (s), s/he may request, without cause, immediate replacement of said contract physician (s).

2.8.4. The CO and COR shall deal with issues raised concerning Contract physician (s) conduct. The final arbiter on questions of acceptability is the CO.

2.9. Contingency Plan: Because continuity of care is an essential part of VAMC’s medical services, The Contractor shall have a contingency plan in place to be utilized if the contract physician (s) leaves Contractor’s employment or is unable to continue performance in accordance with the terms and conditions of the resulting contract.

3. VA HOURS OF OPERATION/SCHEDULING:

3.1. VA Business Hours: Monday – Friday, 8:00 AM – 4:30 PM. The main hospital is open 24/7.

3.2. Work Schedule:

3.2.1. Off-hours Coverage: Contractor must make the contract physician (s) available on-call during all hours when the Togus VAMC clinic is closed, including evenings, weekends and holidays:

3.2.1.1. Weekday evening call will start at 4:00 PM and will conclude at 07:00 AM the following non-holiday weekday morning;

3.2.1.2. Weekend call will start on Friday at 4:00 PM and conclude at 07:00 AM the first non-holiday weekday;

3.2.1.3. Holiday call will start at the close of the regularly scheduled day (usually 4:00 PM or at any time the Director of VA Maine determines) and conclude the following morning at 07:00 AM.

3.2.2. On-call contract physicians must be available within 15 minutes for phone consultations with VA residents and physicians.

3.2.3. Provides dialysis within 6 hours when medically indicated.

3.2.4. Provider must live within 90 minutes of Togus VAMC.

3.3. Federal Holidays: The following holidays are observed by the Department of Veterans Affairs:

· New Year’s Day

· President’s Day

· Martin Luther King’s Birthday

· Memorial Day

· Independence Day

· Labor Day

· Columbus Day

· Veterans Day

· Thanksgiving

· Christmas

· Any day specifically declared by the President of the United States to be a national holiday.

4. CONTRACTOR RESPONSIBILITIES

4.1. Clinical Personnel Required: The Contractor shall provide contract providers (s) who are competent, qualified per this performance work statement and adequately trained to perform assigned duties.

4.1.1. Physicians must meet all the requirements identified in the VA Qualification Standard for Licensed Physician, VM-0602 as set forth in VA Handbook 5005, Part II, Appendix G2 dated April 15, 2002. Additionally, candidates must comply with all policies and procedures related to the Credentialing and Privileging of Licensed Independent Practitioners.

4.1.2. Education: Degree of Doctor of Medicine or an equivalent degree resulting from a course of education in medicine or osteopathic medicine. The degree must have been obtained from one of the schools approved by the Sec. of Veterans Affairs (verifiable at http://ope.ed.gov/accreditation/) for the year in which the course of study was completed.

4.1.2.1. Approved schools are:

4.1.2.1.1. Schools of medicine holding regular institutional membership in the Association of American Medical Colleges for the year in which the degree was granted.

4.1.2.1.2. Schools of osteopathic medicine approved by the American Osteopathic Association for the year in which the degree was granted.

4.1.2.1.3. Schools (including foreign schools) accepted by the licensing body of a State, Territory, or Commonwealth (i.e., Puerto Rico), or in the District of Columbia as qualifying for full or unrestricted licensure.

4.1.3. Board Certification: Nephrology providers will maintain their Board Certification, or be eligible, in Nephrology as approved by the American Board of Medical Specialties/American Osteopathic Association.

4.1.4. Licensure and Registration: Physicians will always maintain an unrestricted license to practice medicine in the State of Maine.

4.1.5. Impaired licensure: A physician who has, or has ever had, any license(s) revoked, suspended, denied, restricted, limited, or issues/placed in a probationary status may be appointed only in accordance with provisions of VA Handbook 5005, Part II, appendix G2, Chapter 3, C-section B, paragraph 14.

4.1.6. English language proficiency: Physician as appointed to direct patient care positions must be proficient in spoken and written English as required by 38 U.S.C. 7402(d) and 7407 and (d).

4.1.7. Physical Qualifications: This position requires a full range of physical activity, including lifting, pulling, pushing, reaching above the shoulder, use of fingers and both hands, walking, standing, repeated bending, and ability for rapid mental and muscular coordination simultaneously. However, reasonable accommodations can be made in persons with disabilities.

4.1.8. The physician(s) will have current Basic Life Support (BLS) or Advanced Cardiac Life Support (ACLS) certification.

4.1.9. The physician(s) will have a Federal or Maine DEA certificate.

4.1.10. The physician(s) will be proficient in the use of computerized medical record systems.

4.1.11. Training: Completes all mandatory training including new employee orientation upon arrival at the medical center. In addition, completes any other mandatory training as assigned by the Chief of Medicine or COR. This may include, but is not limited to: Infection Control, Information Security, Fire, Safety, Military Cultural Awareness, Sexual Harassment, etc.

4.2. Standards of Care: The contract physician (s)’ care shall cover the range of Nephrology services as would be provided in a state-of-the-art civilian medical treatment facility and the standard of care shall be of a quality, meeting or exceeding currently recognized TJC, VA and national standards as established by:

4.2.1. American Society of Nephrology (ASN): http://www.asn-online.org/education/training/fellows/educational-resources.aspx#Guidelines

4.2.2. The professional standards of the Joint Commission (TJC) http://www.jointcommission.org/standards_information/standards.aspx

4.2.3. The standards of the American Hospital Association (AHA) http://www.hpoe.org/resources?show=100&type=8 and;

4.2.4. The requirements contained in this PWS

4.3. MEDICAL RECORDS

4.3.1. Authorities: Contract provider (s) providing healthcare services to VA patients shall be considered as part of the Department Healthcare Activity and shall comply with the U.S.C.551a (Privacy Act), 38 U.S.C. 5701 (Confidentiality of claimants records), 5 U.S.C. 552 (FOIA), 38 U.S.C. 5705 (Confidentiality of Medical Quality Assurance Records) 38 U.S.C. 7332 (Confidentiality of certain medical records), Title 5 U.S.C. § 522a (Records Maintained on Individuals) as well as 45 C.F.R. Parts 160, 162, and 164 (HIPAA).

4.3.2. HIPAA: This contract and its requirements meet exception in 45 CFR 164.502(e), and do not require a BAA in order for Covered Entity to disclose Protected Health Information to: a health care provider for treatment. Based on this exception, a BAA is not required for this contract. Treatment and administrative patient records generated by this contract or provided to the Contractors by the VA are covered by the VA system of records entitled ‘Patient Medical Records-VA’ (24VA19). Contractor generated VA Patient records are the property of the VA and shall not be accessed, released, transferred, or destroyed except in accordance with applicable laws and regulations. Contractor shall ensure that all records pertaining to medical care and services are available for immediate transmission when requested by the VA. Records identified for review, audit, or evaluation by VA representatives and authorized federal and state officials, shall be accessed on-site during normal business hours or mailed by the Contractor at his expense. Contractor shall deliver all final patient records, correspondence, and notes to the VA within twenty-one (21) calendar days after the contract expiration date.

4.3.3. Disclosure: Contract provider (s) may have access to patient medical records: however, Contractor shall obtain permission from the VA before disclosing any patient information. Subject to applicable federal confidentiality or privacy laws, the Contractor, or their designated representatives, and designated representatives of federal regulatory agencies having jurisdiction over Contractor, may have access to VA ‘s records, at VA’s place of business on request during normal business hours, to inspect and review and make copies of such records. The VA will provide the Contractor with a copy of VHA Handbook 1907.1, Health Information management and Health Records and VHA Handbook 1605.1, Privacy and Release of Information. The penalties and liabilities for the unauthorized disclosure of VA patient information mandated by the statutes and regulations mentioned above, apply to the Contractor.

4.3.4. Professional Standards for Documenting Care: Care shall be appropriately documented in medical records in accordance with standard commercial practice and guidelines established by VHA Handbook 1907.01 Health Information Management and Health Records: https://www.va.gov/vhapublications/ViewPublication.asp?pub_ID=3088 and all guidelines provided by the VAMC.

4.3.5. Release of Information: The VA shall maintain control of releasing any patient medical information and will follow policies and standards as defined, but not limited to Privacy Act requirements.

4.4. Direct Patient Care: 100% of the time involved in direct patient care.

4.4.1. Per the qualification section of this PWS, the Contractor shall provide the following staff:

4.4.1.1. Board Eligible/Board Certified Nephrologist(s)

4.4.1.1.1. Maximum of 10 providers.

4.4.2. Scope of Care: Contract physician(s) (as appropriate and within scope of practice/privileging) shall be responsible for providing Nephrology care, including, but not limited to:

4.4.2.1. Clinical Care: Contractor physicians(s) shall provide clinical Nephrology services.

4.4.2.1.1. Contract physician(s) shall respond by telephone within 15 minutes.

4.4.2.1.2. Contractor physician(s) shall provide in-person consultative services at the patient’s bedside within 90 minutes of request.

4.4.2.1.3. Contractor physician(s) shall provide dialysis within 6 hours when medically indicated.

4.4.2.1.4. At the discretion of the contractor physician, the patient may be transferred to a more suitable medical site.

4.4.2.1.5. In the event that transfer of the patient is deemed to be necessary, it is the responsibility of the contractor physician to make the necessary arrangements per the Emergency Medical Treatment and Active Labor Act (EMTALA).

4.4.2.1.6. Guidelines:

4.4.2.1.6.1. A defining principle is to keep care within the VA system when feasible and clinically appropriate.

4.4.2.1.6.2. Examples of patients that may need to be transferred include but are not exclusive of are:

4.4.2.1.6.2.1. Drug intoxications that may need dialysis

4.4.2.1.6.2.2. Pulmonary-renal syndrome

4.4.2.1.6.2.3. Any patient requiring plasmapheresis

4.4.2.1.6.2.4. Any patient on peritoneal dialysis

4.4.2.1.6.2.5. Any patient not deemed suitable for Togus VAMC

4.4.2.1.6.2.6. Inability of the vascular service to place a functional dialysis access

4.4.2.1.6.2.7. Patient whose care will require a multidisciplinary approach. Services which are not readily accessible on an emergency basis currently include Rheumatology and Hematology.

4.4.2.2. Medications: Contractor provider(s) shall follow all established medication policies and procedures. No sample medications shall be provided to patients.

4.4.3. ADMINISTRATIVE: 0% of time not involved in direct patient care

4.4.3.1. Patient Safety Compliance and Reporting: Contract physician (s) shall follow all established patient safety and infection control standards of care. Contract physician (s) shall make every effort to prevent medication errors, falls, and patient injury caused by acts of commission or omission in the delivery of care. All events related to patient injury, medication errors, and other breeches of patient safety shall be reported to the COR VA Safety Policy. As soon as practicable (but within 24 hours) Contractors shall notify COR of incident and submit to the COR the Patient Safety Report, following up with COR as required or requested.

4.5. PERFORMANCE STANDARDS, QUALITY ASSURANCE (QA) AND QUALITY IMPROVEMENT(QI)

4.5.1. Quality Management/Quality Assurance Surveillance: Contractor provider(s) shall be subject to Quality Management measures, such as patient satisfaction surveys, timely completion of medical records, and Peer Reviews. Methods of Surveillance: Focused Provider Practice Evaluation (FPPE) and Ongoing Provider Practice Evaluation (OPPE). Contractor performance will be monitored by the government using the standards as outlined in this Performance Work Statement (PWS) and methods of surveillance detailed in the Quality Assurance Surveillance Plan (QASP). The QASP shall be attached to the resultant contract and shall define the methods and frequency of surveillance conducted.

4.5.2. Patient Complaints: The CO will resolve complaints concerning Contractor relations with the Government employees or patients. The CO is final authority on validating complaints. In the event that The Contractor is involved and named in a validated patient complaint, the Government reserves the right to refuse acceptance of the services of such personnel. This does not preclude refusal in the event of incidents involving physical or verbal abuse.

4.5.3. The Government reserves the right to refuse acceptance of any Contractor personnel at any time after performance begins, if personal or professional conduct jeopardizes patient care or interferes with the regular and ordinary operation of the facility. Breaches of conduct include intoxication or debilitation resulting from drug use, theft, patient abuse, dereliction or negligence in performing directed tasks, or other conduct resulting in formal complaints by patient or other staff members to designated Government representatives. Standards for conduct shall mirror those prescribed by current federal personnel regulations. The CO and COR shall deal with issues raised concerning Contractor’s conduct. The final arbiter on questions of acceptability is the CO.

4.5.4. Performance Standards:

4.5.4.1. Measure: Timely Communication

Performance Requirement: Timely Communication Standard: Returns pages within 15 minutes via telephone, reports on-site within 90 minutes in-person and provides dialysis within six (6) hours when appropriate.

Acceptable Quality Level: Meets 75% of requirement.

Surveillance Method: Review of complaints by requesting provider Frequency: When reported.

Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation.

4.5.4.2. Measure: Provider Medical Record Documentation

Performance Requirement: Medical Record Documentation Standard: Medical Staff Rules and Regulations. OPPE documentation for all (100%) staff providing services under the contract. All staff (100%) meet standards.

Acceptable Quality Level: 95% meet Standards Surveillance Method: Delinquent Reports and Ongoing Provider Performance Evaluation (OPPE) data pertinent to care performed for each provider working under this contract. OPPE data will review the following elements:

Frequency: Initial 90 Days from start of contract and every 6 months thereafter Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation

4.5.4.3. Measure: Quality of Care

Performance Requirement: All contract physicians will provide quality medical care in accordance with usual and customary standards.

Standard: 100% of contract physicians will provide quality medical care in accordance with usual and customary standards.

Acceptable Quality Level: Limited. Peer complaints; Level 2 or 3 review assessments Surveillance Method: Sentinel Events and OPPE Frequency: When reported Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation

4.5.4.4. Measure: Mandatory Training

Performance Requirement: Contractor shall complete all required training on time per VAMC policy Standard: All (100%) of required training is complete on time by contract physician (s).

Acceptable Quality Level: 100% completions, no deviations.

Surveillance Method: Training Records Frequency: Ongoing Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation

4.5.4.5. Measure: Invoicing

Performance Requirement: Contractor invoices VA Maine in equal monthly installments Standard: All (100%) invoices will be billed in equal monthly installments.

Acceptable Quality Level: All (100%) invoices will be billed in equal monthly installments 100% of the time. No deviations accepted.

Surveillance Method: Upon receipt of invoice.

Frequency: Monthly Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation

4.5.4.6. Measure: Qualifications of Key Personnel

Performance Requirement: All contract physician(s) shall be Board Eligible/Board Certified in accordance with American Board of Internal Medicine’s Nephrology Standards.

Standard: All (100%) contract physicians are Board Eligible/Board Certified.

Acceptable Quality Level: 100% No deviations accepted.

Surveillance Method: Upon receipt of applicant referral Frequency: Upon presentation Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation

4.5.4.7. Measure: Maintains licensing, registration, and certification Performance Requirement: Updated Licensing, registration and certification shall be provided as they are renewed. Licensing and registration information kept current.

Standard: All (100%) licensing, registration(s) and certification(s) for contract physician (s) shall be provided as they are renewed. Licensing and registration information kept current.

Acceptable Quality Level: All (100%) licensing, registration(s) and certification(s) for contract physician (s) shall be provided as they are renewed. Licensing and registration information kept current. No acceptable deviation.

Surveillance Method: Licensing, registration and certification records.

Frequency: Ongoing Incentive: Favorable contactor performance evaluation.

Disincentive: Unfavorable contractor performance evaluation e

4.5.4.8. Measure: Privacy, Confidentiality and HIPPA

Performance Requirement:

Standard: All (100%) contractor physician (s) comply with all laws, regulations, policies and procedures relating to Privacy, Confidentiality and HIPPA Acceptable Quality Level: 100% compliance; no deviations.

Surveillance Method: Review of complaints/events;…